<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>Enter Incomes</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="add" method=post>
             <div class=_50> 
                <p><label for=datepicker>Date</label>
                    <input type=date id="dondate" name="dondate" class="required" value=""/></p> 
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Receipt No</label> 
                    <input id="recno" name="recno" class="required" class="input-xlarge" type="text" value=""/></p> 
            </div>  
        
            <div class=_50> 
                <p><label for=textarea>Description</label>
                    <input id="description" name="description" class="required" type="text" value=""/></p> 
            </div> 
                
            <div class=_50> 
                <p><label for=textarea>Total</label>
                    <input id="total" name="total" class=r"required" type="double" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=textarea>Conference Total</label>
                    <input id="contotal" name="contotal" class=r" " type="double" value=""/></p> 
            </div> 

            <div class=_50> 
                <p><label for=textarea>Tithe</label>
                    <input id="contithe" name="contithe" class="" type="double" value="" size="small"/></p> 
            </div> 

            <div class=_50> 
                    <p><label for=datepicker>Conf Planned Giving</label>
                     <input id"conplangive" name="conplangive" class="input-small"  type="double" value="" size="medium" /></p> 
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Conf Thanks Offering</label>
                    <input id="conthanks" name="conthanks" type="double" class=" " value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Conf Loose Offering</label>
                    <input id="conloose" name="conloose" type="double" class=" " value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Conf Mission Offering</label>
                    <input id="conmission" name="conmission" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Conf Other Income(s)</label>
                    <input type="double" id="conothers" name="conothers" class=""  value=""/></p> 
            </div>
            
            <div class=_50> 
                <p><label for=textarea>District Total </label>
                    <input id="disttotal" name="disttotal" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Dist Planned Giving</label>
                    <input id="distplangive" name="distplangive" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Dist Other Income(s)</label>
                    <input id="distothers" name="distothers" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Local Total Income</label>
                    <input id="loctotal" name="loctotal" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Local Poor-Needy Offering</label>
                    <input id="locpoorandneedy" name="locpoorandneedy" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Planned Giving</label>
                    <input id="locplangive" name="locplangive" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Thanks Offering</label>
                    <input id="locthanks" name="locthanks" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Loose Offering</label>
                    <input id="locloose" name="locloose" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Sab Sch Offering</label>
                    <input id="locsabsch" name="locsabsch" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Sab Sch Study Guide</label>
                    <input id="locsabschbooks" name="locsabschbooks" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Children Sab School</label>
                    <input id="locchnsab" name="locchnsab" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Welfare</label>
                    <input id="locwelfare" name="locwelfare" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Funeral Offering</label>
                    <input id="locfuneral" name="locfuneral" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Project Offering</label>
                    <input id="locproject" name="locproject" type="double" class="" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Loc Other Offerings</label>
                    <input id="locothers" name="locothers" type="double" class="" value=""/></p> 
            </div>

            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 
                <ul class=actions-right> 
                    <li><input type=submit id="Save-Incom " class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 